By skyforbes 
If you’re hearing a lot about Ozempic®, Wegovy®, Mounjaro®, or Zepbound®, you’re not alone. GLP-1 medications have become a game-changer in weight management.
Many of my patients are curious about them but understandably have lots of questions. While I’m not a medical doctor and cannot prescribe these medications, I often explain how they work, their benefits and downsides, and how to use them safely. Then I help with the nutrition before, during, and after taking any GLP-1s.
This blog breaks it all down so that you can have a more informed conversation with your healthcare provider. Buckle up! It’s a long read, but one that should help you better understand your options.
What Are GLP-1 Meds?
GLP‑1 receptor agonists (GLP‑1 RAs), also known as incretin mimetics and anti-obesity medications (AOMs), are drugs originally developed to treat type 2 diabetes. Today, their use has expanded to include weight management, conditions like heart disease, chronic kidney disease (CKD), fatty liver, sleep apnea, and even some mental health and reward-related disorders (such as alcohol use disorder).
GLP‑1 stands for glucagon-like peptide-1, which is a natural hormone your body makes. These medications work by mimicking that hormone to:
- Increase feelings of fullness
- Slow down how quickly food leaves your stomach (so you stay full longer)
- Reduce appetite
- Improve blood sugar levels
- Lessen food cravings
Thanks to these effects, GLP‑1 RAs not only help manage blood sugar but also support long-term weight loss and improve overall metabolic health.
It’s important to understand that the GLP-1 produced naturally by the body is short-lived, with effects lasting only a few minutes to a couple of hours. In contrast, GLP-1 medications are engineered to be much longer-acting, which is why they only need to be injected once a week.
GLP-1 Medications Currently Used for Weight Loss
There are currently two main types of GLP-1 medication approved and widely used for weight loss: semaglutide and tirzepatide. An older option, liraglutide, is still prescribed in some cases. More medications are in development and expected to be available in the coming years.
What is Semaglutide?
Semaglutide is a medication that mimics the GLP-1 hormone to help lower blood sugar and support weight loss.
Brand Names:
- Wegovy® – FDA-approved specifically for weight loss
- Ozempic® – FDA-approved for type 2 diabetes, but often prescribed off-label for weight loss
Generic Versions:
- There are no generic versions of semaglutide available at this time.
Compounded Semaglutide:
How It’s Taken:
- A once-weekly injection (there is no oral option approved for weight loss)
Weight Loss
In clinical trials, participants taking semaglutide lost an average of 15% of their body weight over the course of 68 weeks—that’s a little over a year. This means someone who weighed 200 pounds could lose around 30 pounds. Results varied, of course, but many people experienced steady and meaningful weight loss when the medication was combined with lifestyle changes, such as healthy eating and increased physical activity.
In a separate trial, at 208 weeks, users of semaglutide maintained a 10.2% weight loss.
What is Tirzepatide?
Tirzepatide also mimics the GLP-1 hormone to support significant weight loss. In addition, it also simulates the GIP hormone, which works to regulate blood sugar.
Brand Names:
- Zepbound® – FDA-approved for weight loss
- Mounjaro® – FDA-approved for type 2 diabetes, but also prescribed off-label for weight loss
Generics:
- No generic versions of tirzepatide are currently available.
Compounded Tirzepatide:
How It’s Taken:
Weight Loss
Clinical studies have shown weight loss of ~21% of body weight over a 72-week period, which is among the highest reported for a medication to date.
What’s the Difference Between Semaglutide and Tirzepatide?
While both medications work by activating the GLP-1 receptor, tirzepatide is a dual agonist—it targets GLP-1 and GIP (glucose-dependent insulinotropic polypeptide), another hormone that helps regulate blood sugar and appetite.
How to Qualify for GLP-1 Meds?
These medications are typically prescribed for:
- Adults with a BMI ≥ 30
- Adults with a BMI ≥ 27 who also have a weight-related health condition, such as:
- Type 2 diabetes
- High blood pressure
- High cholesterol
- Cardiovascular disease
- Semaglutide is also approved in children 12 years and older living with obesity.
Important Note: These are prescription medications that must be taken under medical supervision. They’re not suitable for everyone.
Contraindications:
While GLP-1 medications can be highly effective for weight loss, they aren’t safe for everyone. Semaglutide and tirzepatide are not recommended for individuals with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2 (MEN2) and pregnant women. They should also be used cautiously—or avoided altogether—in people with a history of pancreatitis, certain gallbladder conditions, or severe gastrointestinal disorders.
As with any prescription medication, GLP-1 agonists must be used under the guidance of a qualified healthcare provider.
Do You Regain Weight After Stopping Semaglutide and Tirzepatide?
Yes, weight regain is common after stopping GLP-1 medications like semaglutide (Wegovy, Ozempic) and tirzepatide (Zepbound, Mounjaro), especially if lifestyle changes aren’t maintained.
Clinical studies have shown that people can regain a significant portion of the weight they lost—on average, about two-thirds—within a year of stopping the medication.
Read about how to keep weight off after stopping Zepbound.
Costs:
Out-of-pocket costs can range from $25 to $1,400 per month. Insurance will often cover these medications for diabetes but less often for weight management. Check your coverage ahead of time to avoid surprises.
The good news?
Eli Lilly, the manufacturer of Mounjaro and Zepbound, now offers the more affordable options through Lilly Direct.
Novo Nordisk is also working on making semaglutide (Ozempic and Wegovy) more affordable. At the time of writing this blog, Novo had a special offer that significantly cut the price of the first month of the medication.
Benefits
Semaglutide (Ozempic and Wegovy):
Tirzepatide (Mounjaro and Zepbound)
- Significant weight loss
- Dual-action effect: Targets both GLP-1 and GIP receptors to enhance appetite regulation and glucose control
- Reduced appetite and improved satiety: Helps you feel full longer and reduces food intake
- Improved blood sugar control: Particularly beneficial for individuals with type 2 diabetes or insulin resistance
- Fewer food cravings, especially for high-calorie, highly processed foods
- May lower risk of obesity-related conditions, such as cardiovascular disease and metabolic syndrome
- Approved for the treatment of sleep apnea
Potential Downsides and Side Effects
As with any medication, there are some potential drawbacks:
- Digestive issues are the most common:
- Nausea
- Constipation
- Diarrhea
Bloating or burping
- More serious side effects:
- Pancreatitis – Inflammation of the pancreas; symptoms include severe abdominal pain, nausea, and vomiting
- Gallbladder disease – Including gallstones and inflammation (cholecystitis)
- Thyroid tumors – Including a potential risk of medullary thyroid carcinoma (MTC); not recommended for individuals with a personal or family history of MTC or MEN2 (Multiple Endocrine Neoplasia syndrome type 2)
- Kidney problems – Worsening of kidney function, especially in those with preexisting kidney issues and during severe nausea/vomiting
- Severe gastrointestinal issues – Persistent nausea, vomiting, diarrhea, or constipation leading to dehydration
- Allergic reactions – Rare but possible; signs include rash, itching, swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing
- Cost and access: Insurance may not always cover these medications
- Long-term use may be necessary to maintain weight loss
- Muscle loss may occur if weight loss is too rapid or if you’re not exercising or eating enough protein
Why Nutrition and Exercise Still Matter
GLP-1 medications can be powerful tools for weight loss, but they aren’t a cure-all. Healthy lifestyle habits—especially good nutrition and regular exercise—remain essential for long-term success. A balanced diet helps preserve muscle mass during weight loss, prevents nutrient deficiencies, and reduces common side effects like constipation (hello, fiber!).
Meanwhile, exercise supports muscle strength, boosts metabolism, promotes heart health, and improves energy and mood. These habits not only enhance the effectiveness of the medication but also set the foundation for maintaining your progress—even if you eventually stop taking the medication.
How to Talk to Your Doctor About GLP-1 Medications
Bringing up GLP-1 medications like Ozempic, Wegovy, Mounjaro, or Zepbound with your healthcare provider can feel intimidating. But it doesn’t have to be. Your doctor’s goal is to support your health, and having an open, honest conversation is the first step.
Here are a few tips to help guide your discussion:
- Be clear about your goals. Whether it’s weight loss, managing a health condition, or preventing future issues, sharing your motivation helps your provider understand your priorities.
- Ask if you meet the criteria. You can say:
“Do I qualify for GLP-1 medications based on my BMI or health history?” - Mention any weight-related conditions. High blood pressure, type 2 diabetes, PCOS, or sleep apnea may affect your eligibility.
- Discuss your full health history. Be sure to mention any past digestive issues, thyroid problems, family history of thyroid cancer, and history of pancreatitis.
- Ask about the risks and benefits. For example: “What side effects should I watch for?” or “What labs or follow-up visits would I need?”
- Be honest about your lifestyle. These medications work best when combined with healthy habits. Talk about your nutrition and activity levels, and ask where to start if you’re not sure.
Remember, your doctor is there to support you. It’s okay to advocate for yourself and ask questions—you’re a partner in your care. However, not all doctors are knowledgeable about or agree with this new generation of weight-loss medication, and it’s fine to seek a physician or other healthcare provider willing to have an open conversation with you.
If possible, seek the advice of an obesity specialist.
Final Thoughts
GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound have become powerful tools in the treatment of excess weight. They can be highly effective, but like any tool, they work best when combined with healthy eating, regular physical activity, and the guidance of a qualified healthcare provider.
As a dietitian who works closely with patients using these medications, I’ve seen how they can truly transform the approach to weight management. Beyond weight loss, GLP-1s are also showing promise for managing other chronic health conditions. That said, they’re still relatively new, and I continue to follow the emerging research closely.
Do I recommend them? I view them as one of many treatment options. When a patient is interested, I provide an overview of the pros and cons and always encourage a conversation with a knowledgeable physician to help determine if it’s the right path.
If you’re thinking about trying a GLP-1 medication, speak with your doctor to see if it aligns with your goals and lifestyle. And remember, no matter which treatment you choose, your daily habits remain the foundation of long-term success.